Active NPI
Marilyn Huguette Lavallee, M.D.
- Internal Medicine Physician
- Savannah, GA
National Provider Identifier
1891734737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 053623
- Practice address
- 513 E Oglethorpe Ave Ste F
Savannah, GA 31401-4141 - Phone
- (912) 999-8899
- Fax
- (912) 480-0010
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 053623 | GA | Primary |
Addresses
Primary practice location
513 E Oglethorpe Ave Ste F
Savannah, GA 31401-4141
Mailing address
513 E Oglethorpe Ave Ste F
Savannah, GA 31401-4141
Phone (912) 999-8899
Other practice location 1
1001 Memorial Ln
Savannah, GA 31410-1220
Phone (912) 897-3766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53263 | Other | GA | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053623 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1891734737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 E OGLETHORPE AVE STE F",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314014141",
"telephone_number": "912-999-8899",
"fax_number": "912-480-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 E OGLETHORPE AVE STE F",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314014141",
"telephone_number": "912-999-8899",
"fax_number": "912-480-0010"
}
],
"practiceLocations": [
{
"address_1": "1001 Memorial Ln",
"address_purpose": "LOCATION",
"city": "Savannah",
"state": "GA",
"postal_code": "314101220",
"country_code": "US",
"telephone_number": "912-897-3766",
"fax_number": "912-898-0809",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAVALLEE",
"first_name": "MARILYN",
"middle_name": "HUGUETTE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "053623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "53263",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.